<form name="feedback" method="post" action="feedback_send.php">

<table width="450px">
<tr>
 <td colspan="2" style="text-align:center">
  <h2> Your Feedback </h2>
 </td>
</tr>

<tr>
 <td valign="top">
  <label for="first_name">First Name </label>
 </td>
 <td valign="top">
  <input type="text" name="first_name" maxlength="50" size="30">
 </td>
</tr>

<tr>
 <td valign="top"">
  <label for="last_name">Last Name </label>
 </td>
 <td valign="top">
  <input type="text" name="last_name" maxlength="50" size="30">
 </td>
</tr>

<tr>
 <td valign="top">
  <label for="email">Email Address </label>
 </td>
 <td valign="top">
  <input type="text" name="email" maxlength="80" size="30">
 </td>
</tr>

<tr>
 <td valign="top">
  <label for="comments">Comments </label>
 </td>
 <td valign="top">
  <textarea name="comments" maxlength="1000" cols="25" rows="6"></textarea>
 </td>
</tr>

<tr>
 <td colspan="2" style="text-align:center">
  <input type="submit" value="Submit">
 </td>
</tr>
</table>

</form>